Avoid the Trap

Gillett, Dan; Mitchell, M. A.; Dhaliwal, Inderdeep

doi:10.1016/j.chest.2021.04.025

Cited by 5 publications

(5 citation statements)

References 46 publications

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“…analysed the agreement of TL by multiple clinicians in two MPE cohorts and found only fair to moderate agreement ( κ 0.38–0.51) 10 . Previous studies used various definitions for TL, such as ‘incomplete’, ‘<50% apposition’ and ‘<75% apposition’ of the lung and chest wall on radiographs 3,10–13 . Our survey reflects this ambiguity, with significant portions of respondents defining TL as any amount of incomplete lung expansion, while others considered TL as over 25% of non‐apposition.…”

Section: Discussionmentioning

confidence: 79%

“…10 Previous studies used various definitions for TL, such as 'incomplete', '<50% apposition' and '<75% apposition' of the lung and chest wall on radiographs. 3,[10][11][12][13] Our survey reflects this ambiguity, with significant portions of respondents defining TL as any amount of incomplete lung expansion, while others considered TL as over 25% of non-apposition. As TL strongly impacts treatment choice, such variations must be addressed in future research.…”

Section: Discussionmentioning

confidence: 99%

“…Trapped lung (TL) complicates up to 30% of MPEs as a result of malignant visceral pleura thickening or endobronchial obstruction. 3,4 Decortication, that is, surgical removal of the visceral peel, is considered by traditional teaching as a means to re-expand the underlying TL. 5 If it cannot be decorticated, management of TL transitions to reducing symptoms caused by MPE reaccumulation.…”

Section: Introductionmentioning

confidence: 99%

“…Pleurodesis can aid long‐term MPE control but is only feasible if the underlying lung fully expands to allow apposition of the visceral and parietal pleura. Trapped lung (TL) complicates up to 30% of MPEs as a result of malignant visceral pleura thickening or endobronchial obstruction 3,4 . Decortication, that is, surgical removal of the visceral peel, is considered by traditional teaching as a means to re‐expand the underlying TL 5 .…”

Section: Introductionmentioning

confidence: 99%

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Management of malignant pleural effusion and trapped lung: a survey of respiratory physicians and thoracic surgeons in Australasia

Sidhu,

Wright,

Peddle‐McIntyre

et al. 2024

Internal Medicine Journal

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BackgroundMalignant pleural effusions (MPEs) are common, and a third of them have underlying trapped lung (TL). Management of MPE and TL is suspected to be heterogeneous. Understanding current practices in Australasia is important in guiding policies and future research.AimsElectronic survey of Australia‐New Zealand respiratory physicians, thoracic surgeons and their respective trainees to determine practice of MPE and TL management.ResultsOf the 132 respondents, 56% were respiratory physicians, 23% were surgeons and 20% were trainees. Many respondents defined TL as >25% or any level of incomplete lung expansion; 75% would use large‐volume thoracentesis to determine whether TL was present. For patients with TL, indwelling pleural catheters (IPCs) were the preferred treatment irrespective of prognosis. In those without TL, surgical pleurodesis was the most common choice if prognosis was >6 months, whereas IPC was the preferred option if survival was <3 months. Only 5% of respondents considered decortication having a definite role in TL, but 55% would consider it in select cases. Forty‐nine per cent of surgeons would not perform decortication when the lung does not fully expand intra‐operatively. Perceived advantages of IPCs were minimisation of hospital time, effusion re‐intervention and usefulness irrespective of TL status. Perceived disadvantages of IPCs were lack of suitable drainage care, potentially indefinite duration of catheter‐in‐situ and catheter complications.ConclusionThis survey highlights the lack of definition of TL and heterogeneity of MPE management in Australasia, especially for patients with expandable lungs. This survey also identified the main hurdles of IPC use that should be targeted.

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Section: Discussionmentioning

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Management of malignant pleural effusion and trapped lung: a survey of respiratory physicians and thoracic surgeons in Australasia

Sidhu,

Wright,

Peddle‐McIntyre

et al. 2024

Internal Medicine Journal

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“…To identify and treat the underlying causes of pleural inflammation and to avoid the progression to trapped lung and high morbidity associated with multiple invasive diagnostic procedures, early evaluation of pleural effusion is very important, although pleural fluid drainage might not always provide clinical relief to the patients [1,5]. Herein, we describe a case of trapped lung who presented to our hospital with chronic unilateral pneumothorax.…”

Section: Introductionmentioning

confidence: 99%

Help, My Lung is Trapped! – A Case Report

NP,

et al. 2023

austinjradiol

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Trapped lung is defined as the inability of the lung to expand fully and fill up the thoracic cavity because of a restricting fibrous visceral pleural layer preventing apposition of visceral and parietal pleura. It is a sequela of a previous inflammation of the pleural space and has variety of causes. Chest radiograph and thoracic ultrasound is the key imaging modalities for the diagnosis usually with a history of preceding pleural drainage. Typical imaging features include visceral pleural peel, basal pneumothoraces, ipsilateral volume loss and lobar atelectasis. Management aims at relief of symptoms and enabling full lung re-expansion. It is usually associated with high morbidity, therefore identifying patients with trapped lung is crucial for early treatment and positive patient outcomes. We present a case of trapped lung of a patient with previous history of pulmonary tuberculosis and chronic right pneumothorax.

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